537
Case Report
Images in Infectious Diseases
Revista da Sociedade Brasileira de Medicina Tropical 47(4):537, Jul-Aug, 2014
http://dx.doi.org/10.1590/0037-8682-0058-2014
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Address to: Dr. Guray Demir. Department of Anesthesiology and Reanimation/Bakirkoy Dr. Sadi Konuk Training and Research Hospital. Zuhuratbaba Mh,
34147 Istanbul, Turkey.
Phone: 00 90 21 2414-7171; Fax: 00 90 21 2542-4491
e-mail: guraydemir@hotmail.com
Received 14 March 2014
Accepted 22 May 2014
Diagnosis and excision of a primary hydatid cyst
localized in the soft tissue
Guray Demir
[1], Ali Tekin
[2]and Hande Tekin
[3][1]. Department of Anesthesiology and Reanimation, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. [2]. Department of Pediatric Surgery, Tatvan State Hospital, Bitlis, Turkey. [3]. Department of Pediatrics, Tatvan State Hospital, Bitlis, Turkey.
A 7-year-old boy presented with a painful swelling on his chest wall under the left clavicula. His parents reported that this mass had developed and increased in size within the
previous year. Physical examination showed a fl uctuant mass
(3 × 4 cm) within the indicated region; this mass elicited pain on palpation. Ultrasonographic examination did not reveal any diagnostic clues. Considering that the patient’s family lived in a region endemic for hydatid disease and were involved in livestock farming, the patient underwent further assessments using abdominal and thoracic computed tomography (CT)
examinations, specifi c immunoglobulin E (IgE) tests, and hemagglutination tests to confi rm a diagnosis of hydatid cyst.
The serologic test results were normal. CT did not show any cystic lesions in the liver, lungs, or other intraabdominal organs (Figure A). However, a mass, measuring 28 × 38mm, similar to a unilocular cyst, was observed on the anterior thoracic wall just below the left clavicle (Figure B). For defi nitive diagnosis,
and treatment of the mass, excisional biopsy was scheduled. The mass was excised in compliance with the principles of the surgical procedure; however, the cyst wall ruptured revealing a germinative membrane. The mass was extirpated, and prepared for histopathological examination (Figure C). On the basis of
the fi ndings of the histopathological examination, a diagnosis of hydatid cyst was confi rmed.
1. Vercelli-Retta J, Mañana G, Reissenweber NJ. The cytologic diagnosis of hydatid disease. Acta Cytol 1982; 26:159-168.
2. Ousadden A, Elbouhaddouti H, Ibnmajdoub KH, Mazaz K, Aittaleb K. A solitary primary subcutaneous hydatid cyst in the abdominal wall of a 70-year-old woman: a case report. J Med Case Rep 2011; 5:270. 3. Eckert J, Deplazes P. Biological, epidemiological, and clinical aspects
of echinococcosis, a zoonosis of increasing concern. Clin Microbiol Rev 2004; 17:107-135.
